The lessons science and pharmacology teach us about
achieving optimal health, vitality and maximal lifespan with a low net carb, high saturated fat, evolutionarily paleolithic-styled diet aligned with my ancestral heritage and how I lost 50 pounds of body fat. A sorta fairy story.

Guest Post: Tim Steele (aka Tatertot)While Grace is off touring Europe and no doubt eating some very good food [JUST RETURNED, FOOD AND FERMENTED DISHES ALL AWESOME] , I figured I'd get a jump on steps 5 and 6 so she would have something to do between unpacking her suitcase and rounding up the kids and kittens.

Step #5: WALK

Now, where have we heard that before. Sounds a lot like the Primal Blueprint! If anyone here doesn't know who Mark Sisson and Grok are, now is the time to meet them. Mark Sisson came up with his Primal Blueprint as a way for the average person to implement a paleo diet in a personalized way that works for anyone from beginner to elite athlete. One of the first things you will learn when you start reading the Primal Blueprint is that you don't need to kill yourself running mile after mile. Walking steadily at a slow pace is the much preferred route to health and happiness.

Grace says to walk 10,000 steps and then recommends you do it in an hour . . . hmmmmm. I think her pedometer was broken that day or she was buzzing on lattes, because 10,000 steps is 5 miles by most accounts! But that's OK, we'll give her that one! The takeaway is that you need to get up and get moving. Walk as much as you can. Don't have an hour to spare, take four 15 minute walks, three 20 minute walks, heck--take 10 six-minute walks! Just get walking. Walking is a great way to keep your intestines limber and healthy. If you have a sedentary desk job, it's even more important that you get up during the day and WALK. Tell your boss you took up smoking, then follow the smokers to the smoke shack and do laps around the parking lot while they shorten their lives.

According to this article, "As far back as the late 1950s, a study found that people with sedentary jobs (bus drivers) were twice as likely as those with active jobs (mailmen) to develop cardiovascular disease. More recently, extended daily TV watching and time on the computer-which, like desk jobs, involve long periods of time sitting still-have been linked to a greater risk of metabolic syndrome, a constellation of health problems that can lead to diabetes and heart disease."

Here is a great website for all things walking related if you need some motivation to get started, but seriously, just walk. Get some comfortable shoes and walk. If you are a busy mom chasing kids or a factory worker who is on your feet all day, you probably have the walking part covered, but still, a nice leisurely stroll can be very relaxing and a great way to get outside.

Wasn't that easy!

GRACE: Are you wondering what is peristalsis and myenteric musculo-neuro junctions? Let me expand....

AWESOME Tim~!! I think you are a MASTER ENGINEER for gut health. Thank you for all that you do.10,000 steps isn't that far is it??! For the geeks out there, check out the iPhone/Android app Moves, Activity Tracker for UDS$1.99 (Hat tip: W).

There are two main ways that food and mucus material in the small intestines move along the gut (1) peristalsis and (2) MMC, myenteric migrating complex. Peristalsis is the weak, wiggly movement propagated by the smooth muscle lining the intestinal tract. The myenteric migrating complex on the other hand is powerful and strong, starting from the stomach and vibrating like a heart beat or pacemaker through the small intestines in pulses throughout the day every 90 to 120 minutes. These are known as 'housekeeping waves'. It is also described as 'a band of neural excitation that travels slowly across the stomach and intestines.' The movement quickly shuttles along the contents, mucous, bacteria and fungi out of the small intestines to the large intestines when we are fasting and through out the day. Usually the MMC rhythmic contractions are painless and unnoticed, but for those with IBS or other bowel inflammation, sometimes these are uncomfortable or painful.

The presence of food actually temporarily decreases the MMC propulsive action because the gut needs to slow down for food to be thoroughly digested and absorbed in the small intestine, no? So it is no wonder that high-bolus insulin doses (which mimic eating) will stop the MMC. Guess what subgroup has poor functioning guts, SIBO and MMC? Type 2 diabetes and obese individuals where the MMC is less functional secondary to high insulin levels. Additionally when the BG (blood glucoses) have been pathologically elevated for decades, damage to the nerves that regulate the small intestines can happen and this is known as autonomic neuropathy. The result is abnormal peristalsis, spontaneous contractions, and reduced tightness of the sphincters which grip and prevent intestinal contents from escaping to places they shouldn't (like backward in heartburn/stomach contents or with feces). Part of the charm of exercise is that all of these gut motility issues can be improved or even reversed with routine, regular exercise which improves insulin sensitivity, strengthens smooth muscle, improves the pacemakers of all of organs and calms the nervous system that regulates every organ.

Did you know our small intestines are innervated by 100 million neurons, as many as the spinal cord (Gershon 'The Second Brain')? Therefore innervations to the small intestines can become 'broken' from various conditions which will lead to higher degrees of small intestinal bacterial/fungal overgrowth (aka SIBO/SIFO -- hat tip Keith Bell). Additionally hormone changes and structural tissue damage may also 'break' the sweeping motions that naturally occur in the small intestines leading to pseudoobstructions and SIBO (see HERE for complete list including hypothyroidism, diabetes, autoimmune diseases (celiac), viral damage (CMV, Epstein Barr, herpes zoster), drugs (verapamil, diltiazem)).

Exercise may not entirely erase damage to our second brain in the our guts but it can potently improve inflammation at the intestinal level and condition and strengthen the smooth muscle that control the contractions of the gut (peristalsis, MMC).

When I had CFS (Chronic Fatigue Syndrome) and nearly bed-bound, I couldn't walk a block, let alone 5 miles. If you haven't the capability to walk or jog far, start low and go slow. Consider starting with hydrotherapy or swimming (no gravity) gently at first for only 10 minutes daily and gradually build to tolerance.

48 comments:

I hope people get that app or at least a cheap-o pedometer like I have. It's pretty neat to see how far you actually walk in a day. I usually walk 2-3 miles, just doing my job, and then try to walk an additional 60 minutes either outside or on treadmill in the Winter. I've had jobs and a lifestyle where I would barely walk 200 feet all day long, and it really showed!

Fascinating stuff, thanks. That you say "low-moderate intensity" seems key, since acute exercise is counterintuitively known to cause leaky gut. A lot of athletes report gastrointestinal disturbances. I don't really understand the mechanism, but think it has to due with limited resources, meaning blood is drawn away from the intestines and used in muscles during intensive training. This damages flora.http://ajpregu.physiology.org/content/304/5/R356

I like the pH construct in examining relationship of gut health and exercise (and in general, pH rules, especially in gut-brain connection). There are studies showing bicarbonate enhancing exercise performance, credence for people supplementing with baking soda. http://www.ncbi.nlm.nih.gov/pubmed/24126895

So, what this implies may be an alkalizing diet is key to healing, especially since gastric acid is likely too low for proper digestion anyway. This may not mean people should abstain from meat as some demand of gastric acid is also key to balancing flora. (Side note: can't make gastric acid without zinc as it fuels the required enzyme, carbonic anhydrase. Zinc deficiency is huge, but you can't absorb it with a compromised small intestine, a vicious circle making supplementation necessary.)

So when your acid is pumping you're simultaneously producing bicarbonate released into the bloodstream, alkalizing blood for optimal exercise performance.

Where it gets really interesting is inverse relationships in pH, i.e. metabolic pH (blood) is inversely related to intracellular pH, so if your blood is a healthy alkaline, then cells will be a healthy acidic:http://www.ncbi.nlm.nih.gov/pubmed/9497798http://ajpheart.physiology.org/content/256/5/H1316

Then your cells need to be able to dump acid waste and that's where sulfur is key (OptiMSM as supplement) to make cell walls more permeable allowing acid waste out and good things like insulin/glucose and antimicrobial peptides in to balance intracellular organisms. Who's doing the backstroke in cytosol of your cells, screwing with your genes while making you attack your mitochondria, missing the target? Shut down the invaders. Take a nice walk. And stop shitting in water.

Tim. I would love to hear your story.. I'm also a chronic Fatigue girl, well Adrenal burnout is the best that I know.. So would love to here where you came from and how you discovered this if you are open to telling us.=) I love background. It gives me context

@Kieth - I loved that NPR piece, too. I hadn't even thought to look at the comments there, I can barely keep my thoughts contained lately, let alone find a new place to write about my favorite subject!

@pipparoni - As soon as we get through the SIBO steps, I will see if Grace will let me do a post on my American Gut Project results. My wife and I did the test at the same time and have remarkably different microbe profiles. At that point, you will learn more about us than you'd ever want to know, and see why potato starch/RS is a game-changer!

@kieth - Just another comment, you said 'quit shitting in the water'. I learned a fascinating fact about Cholera today. When a person harboring the vibrio cholerea microbe 'shits in the water', the cholera microbes swim around until they find a starchy plant stem, root, or seed (think: rice paddy) and they cling to it. People eat the food with v. cholerea attached to the starch and complete the life cycle of cholera.

This same effect can rid a person of cholera. If someone has an acute cholera case going on, they fill him with water laced with resistant starch. The cholera leave their burrow in the gut lumen and affix themselves to the RS. The RS, being slowly digested, travels to the large intestine where severe diarrhea is going on and are flushed out of the body--and hopefully not back into the water!

http://www.ncbi.nlm.nih.gov/pubmed/10655529

This effect not just limited to cholera, e. coli and other pathogens as well as bifidobacteria and other probiotics really like RS, too.

UR SO FUNNY. It wasn't crude, you cited Mark Sisson! Pedometer is fantastic. Personally I would never use Moves because of the radiation/EMF from the phone. Heard of too many personal cases of cancer for younger people toting their phones everywhere.

Keith,

ABSOLUTELY!! Thank you for all of your comments! I will digest all of them in the next wk but I agree alkalinity is probably missing from modern diets. When I met Frassetto the author of the paleo diet study, she disclosed she didn't stop all grains (or even pasta). This struck me. She is also a big fan of alkalinity as a renal doctor. Deep, huh? She's done the studies!

I have a couple of triathlete clients and it is challenging keeping their guts healthier and optimal. Thank goodness for Tim, potato starch, and SBO probiotics (readily available here in China)!

ZINC-- i totally concur. Vicous circle. For me, the instant I started taking the SBO probiotics I no longer required eating high doses of salt, mag and zinc (otherwise I'd get severe adrenal issues and hypotension/dizziness -- yes I'm blond but defective adrenals UGH). Healthy flora and health microvilli are mandatory for mineral needs and absorption. You brought up very interesting points also how the pathogenic flora scavenge and eat up zinc and other minerals. Ferritin -- many pathogens scavenge our iron for their own uses.

"Then your cells need to be able to dump acid waste and that's where sulfur is key (OptiMSM as supplement) to make cell walls more permeable allowing acid waste out and good things like insulin/glucose and antimicrobial peptides in to balance intracellular organisms. Who's doing the backstroke in cytosol of your cells, screwing with your genes while making you attack your mitochondria, missing the target? Shut down the invaders. Take a nice walk. And stop shitting in water."

Ha ha you guys crack me up =)Thanks Grace. I've been feeling a lot more . I'm not sure if this is all part of the journey but I seem to be in a grieving process. No resistance happening.. started a week ago. And I'm welcoming it in. I will retes my hair in 3 months I am so excited to see what happens to my minerals and absorption with this .. So far so good.. Thanks Grace again.. You rock !!

Jean - You should go read the entire blog and all the comments that the excerpt you posted came from, it's kind of misleading the way it's laid out on 'eatingoffthefoodgrid'

It came from here: http://www.proteinpower.com/drmike/gerdacid-reflux/gerd-treat-low-high-carb-diet/

It was a back and forth conversation between me and Norm Robillard of Fast Tract Digestion, we are on good terms with each other which is why it doesn't read like either of us is trying to 'one-up' or obliterate each other. It was a friendly discussion.

In the link you posted, the numbered, bolded items were my initial claims, then right underneath that in quotations are Norm's responses, and then my answer to Norm's critiques.

It's funny that about half the people who read it say Norm won the debate and half say I won, but it wasn't a contest--just sharing info on some pretty strong claims I made, that were all backed up with scientific studies.

Norm's deal is treating SIBO by elimintating anything that has the potential to be fermented by bacteria anywhere in the digestive tract--that works to eliminate the bad feelings you get when you have SIBO, but it is a death blow to any hope that your gut will heal and new growth will occur. In a way, it may be worse than antibiotics and PPIs. But, it gives people relief (avoiding fermentable carbs), so it's a popular method amongst low-carbers.

Many have mentioned bone broth as an important part of combatting SIBO and healing the gut. I assume it has calories—yet it was suggested as being consumed during a fast by someone. What is the caloric content? Wouldn’t it “break” a fast?

One of the posts mentioned legumes properly soaked and prepared, but I have heard that there is still enough toxins even after soaking and that it can induce leaky gut… What is the take here?

Also, in regards to malabsorption, I am sooooo starved that I meet the criteria for a starvation wasting disease and am thinner than some Holocaust survivors. Conventional doctors just say to eat more and more and more…. But are there dangers of overfeeding? What is overfeeding when one is not digesting properly and malabsorbing? Is it better to try to eat more in hopes of absorbing more, or does that backfire and create too much gastric stress? Is it better to try to eat normal and when hungry (although what is hunger? I’ve been stuffing myself so long and my stomach hurts so much and seems to digest so poorly, what is hunger?) or to try to push as much food down me as I can?

I’ve heard of some benefits of intermittent fasting, namely provoking autophagy which sounds like it would be helpful for SIBO? Is there a benefit to limiting food intake to an 8 hour window each day in order to try to induce autophagy (the Jaminets in Perfect Health Diet suggest 16 hours as the ideal to induce autophagy)?

I have been fighting this way too long and am seeking some hope. And yes, I am under a doctor’s care.

You walked straight into that one, Jean! There's not much going on anywhere on the internet about RS that I'm not a part of.

I'm going to go out on a limb here, and Grace may completely disagree, but I think that when one has SIBO, RS is KEY to curing it.

1. RS has the proven ability to 'mop up' stray bacteria--good and bad.

2. It takes upwards of 4 hours for RS eating bacteria to begin digesting (fermenting) RS. Food does not stay in the small intestine that long.

3. The digestion (fermentation) of RS is a 2 or 3 step process involving several different bacteria, the chance that all of these different co-feeders are present in the small intestine is improbable.

4. SIBO is a problem of total gut dysfunction more so than simply a bit of bacteria growing out of place. By the time SIBO can occur, lots of damage has been done. Step 1 needs to be overall healing, not removing the one thing (RS) that offers a complete recovery.

When I started supplementing potato starch 10 months ago, I no doubt had SIBO, though undiagnosed. I had bouts of heartburn and indigestion I self-treated with low-carb and Tums. The potato starch caused me absolutely no discomfort and I now eat lots of carbs with no problems. I have not had any indigestion or heartburn pretty much since day 1 of supplementing potato starch.

Anonymous, your situation doesn't seem to fit the SIBO/SIFO construct, but seems more extreme. Have you had the comprehensive Metametrix stool testing or the Organic Acid urine test to know what you may be missing? You may want to research fecal transplant (even DIY as most doctors will likely only perform FMT in cases of C. diff), probiotic enemas and the new pills made from human feces to repopulate the gut:http://www.nature.com/news/faeces-filled-pill-stops-gut-infection-1.13885

Anonymous - I hate comments like yours because I want to find out where you live and come to your house and not leave until you are perfectly healthy.

Since that's probably not going to happen, the most I can do is give you the best advice I can, and hope it makes things better for you.

Since I don't know anywhere near enough about you (age, sex, history) to give you any meaningful medical advice, I would like to say that it looks like you may be searching for magic bullets on the internet.

There are no magic bullets.

IF'ing is a tweak that is used by veteran dieters, and should not be used by people who are having major digestive problems. There does seem to be some evidence that apoptosis occurs with IF'ing, but IF'ing is really just a way to reduce overall calories for maintaining weight.

Not sure where you live or what kind of doctors you have, but hopefully you can find a doc who will order a complete diagnostics of your gut to look for parasites, pathogenic bacteria, heavy metals and that sort of thing. Grace will probably be able to give you some really good advice on what sort of tests to ask for and how to find a good doc in your area.

After saying all that, I would like to say that eating a diet similar to the Perfect Health Diet and following the 7 steps in this series will be nothing but healing for you. Avoid lots of legumes if they cause you discomfort, but generally a long soak ferments most of the toxins out of beans. I think the protein, fiber and RS contained in beans outweighs the minimal anti-nutrients that may be still there, and I doubt they contribute at all to leaky gut in the way that gluten, vegetable oils, and allergens do. But if you are torn, don't eat them--it's that easy!

Also, if I were your best friend, I would urge you to try supplementing with potato starch. Start with 1/2 - 1TBS a day mixed in a cup of yogurt or kefir (if you aren't lactose intolerant). If you can't do milk, mix the PS with water or anything liquid--just don't heat it!

@anonymous Byron Richards just answered a question on his podcast about a girl with an inflamed stomach. Maybe it would help. It starts around 25 minutes. http://www.wellnessresources.com/audio/podcast/2013/podcast_112713.mp3

To all.... Grace, in the post you mentioned (1) peristalsis and (2) MMC, myenteric migrating complex. What is the best eating schedule to accomodate that? I have long heard that it is best to eat 5-6 small meals a day, and recently read some things contradicting that. What do you think?

Also, how important is autophagy to cure SIBO? SHould fasting for 16+ hours be part of a daily regimene? Once a week? Not at all? And does the fast have to be more than 16 hours to induce autophagy? Or is 12 hours sufficient?

I have severe, severe constipation and malabsorption and hypoglycemic (which seems related, hm....) and no doubt SIBO. Would love any advice....

1) Bone broth - Many have mentioned bone broth as an important part of combatting SIBO and healing the gut. I assume it has calories—yet it was suggested as being consumed during a fast by someone. What is the caloric content? Wouldn’t it “break” a fast?

One of the posts mentioned legumes properly soaked and prepared, but I have heard that there is still enough toxins even after soaking and that it can induce leaky gut… What is the take here?

2) Overfeeding? - Also, in regards to malabsorption, I am sooooo starved that I meet the criteria for a starvation wasting disease and am thinner than some Holocaust survivors. Conventional doctors just say to eat more and more and more…. But are there dangers of overfeeding? What is overfeeding when one is not digesting properly and malabsorbing? Is it better to try to eat more in hopes of absorbing more, or does that backfire and create too much gastric stress? Is it better to try to eat normal and when hungry (although what is hunger? I’ve been stuffing myself so long and my stomach hurts so much and seems to digest so poorly, what is hunger?) or to try to push as much food down me as I can?

3) Resistant starch - Would arrowroot starch do the same thing as potato starch?

4) Resistant starch again - If I am following the conversation correctly, resistant starch is essential to fight SIBO? My doctor (who is alternative, paleo-friendly) has me on a starch free diet, pretty much, in order to kill/fight/starve bacteria in my gut. I eat plenty of onions for prebiotics; have a little bit of sweet potato (cooked and then eaten cold after sitting for 24 hours for the resistant starch). But no white potato as the form of starch is different, no fruit, no yucca or taipioca. Is the onion and sweet potato sufficient? Is there wisdom in no starches at all for some time to starve the bacteria?

Finally, would the psylium husk be too irritating to an already inflammed unhappy digestive system? I have heard it is too rough and abrasive.

5) IF and autophagy - I’ve heard of some benefits of intermittent fasting, namely provoking autophagy which sounds like it would be helpful for SIBO? Is there a benefit to limiting food intake to an 8 hour window each day in order to try to induce autophagy (the Jaminets in Perfect Health Diet suggest 16 hours as the ideal to induce autophagy)? Is autophagy essential to combat SIBO? Does the fast need to be 16 plus hours, or is 12 hours sufficient?

I have been fighting this way too long and am seeking some hope. And yes, I am under a doctor’s care.

Oops. Tim, my bad. Yes, I am the same person. I am still learning to navigate the comment system and didn't think my post had been posted, and I thought I had asked for email updates and didn't get any response. I apologize.

Gillian - no problem. I talked Grace into letting comments go through without her having to approve them first, and I was afraid we were getting spammed. That seems to be a common tactic, just reposting earlier stuff to get you to click a link or something.

Grace should be back on-line soon, unless she ate too much at Thanksgiving and exploded.

Hey GORGEOUS. We must have a continuous continuum between us~! ahhaa LOL Grieving processes are not bad -- they're transformative to let go of the old and to be grateful what we do have. Since my brain came back online (after being off-line for 3years) I feel actually mourning for old habits and lifestyles.

As you know I don't give advice but there are several thoughts you should consider exploring.

Adrenal health -- our little bitty adrenal glands which regulate stress and adrenaline and testosterone/progesterone get super unhappy when you are tired, fasting or fatigued excessively. If you read on the internet, hoardes of paleo VLC folks entered into adrenal failure, including myself. If you have been on the SAD since childhood and for several decades like myself, doing VLC or IF is therapeutic for a few months to straighten things out or to decrease yeast or to lose the last 10lbs, but for long term, I believe it places excess strain on an organ already dysregulated by the damage of poor diet.

I don't think there is an 'ideal' meal frequency. Everyone is individual and depending on the health goal, meal frequency is a great tool to achieve health. For adrenal health, I favor 4-5 small meals particularly for people who have hypoglycemia and to avoid all fasting other than 8-10hrs sleep each night. Autophagy will happen natural with all the gut and glands are all coordinated and synchronized in harmony. Make sense?

Have you considered probiotics? Here's a SIBO review (which isnt completely stupid)http://www.medscape.com/viewarticle/811345_print

'Probiotics are another potential treatment for SIBO; however, there are only pilot studies addressing their use. Oneopen-labelled pilot study assessed the effect of Lactobacillus casei Shirota on SIBO patients, where SIBO wasdemonstrated by an early rise in breath H2 after lactulose.[101] Following the 6-week intervention (65 billion bacteria/day),64% of patients no longer had a positive breath test, but there was no significant improvement in abdominal symptoms.In another pilot study, patients were randomised to receive either a probiotic or metronidazole as treatment for SIBO.[102]The probiotic contained Lactobacillus casei,Lactobacillus plantarum,Streptococcus faecalis and Bifidobacterium brevis.A statistically significant difference in symptomatic response favoured the use of the probiotic over the antibiotic (P =0.036).'

I found that SBO (soil based probiotics) fix nearly all gut problems -- including severe constipation. Are you dairy-free and gluten-free? Are you sugar-free?

If you still suffer, make your conventional doc collaborate with shiny new functional medicine practitioner (like me) to target exactly what is going on in your gut. Consider the value of assessing--modern toxins, mercury, pesticide load--adrenal health (ALL HEALTH HINGES ON HAPPY ADRENALS)--gut health and gut parasites, protozoa, worms, and pathogenic overgrowths

Bone broth is bionic food -- contains amino acids that the gut uses to rebuild (glycine) and contains minerals that are easy to digest and assimilate.

Malabsorption can be several things. SIBO/SIFO (small intestinal bacterial/fungal overgrowth) can destroy the integrity of the absorptive surface in the small intestines. The stomach also may secrete less gastric acid either from SIBO/SIFO damage or broken nerve messages. I like assessing exactly that is present in the gut because protozoa, parasites, worms and overgrowths all do all the above. You may drink all the bone broth under the sun and starve all the critters your naturopath thinks you're starving, but in the end the protozoa, parasites, worms and overgrowths can still fester and swarm.

Whilst starving, you can lose inordinate amounts of zinc and magnesium (as burning fat and ketones exclusively will do that) and hopefully not develop a heart arrhythmia or brain seizure from mag or zinc deficiencies.

Dr. Grace, Thank you so incredibly much for taking the time to respond.

I have been on adrenal support stuff through my doctor—they were way messed up but seem to be a little more regulated now.

I was vegetarian until January of last year when I switched to the Perfect Health Diet/Paleo out of desperation.

4-5 small meals—for the MMC to work properly, is it necessary to space them out every 3-5 hours?

And I’m on probiotics, dairy-free, gluten-free, grain-free, corn-free, soy-free, sugar-free, you name it free practically…. Only eating home-prepared meat and veggies, simple. I’ve been detoxed (I did have EXTREME aluminum toxicity and other toxicity), had Lyme’s disease pathogens and others killed…. And still so tired, live on a laxative because otherwise nothing moves, still pain in the stomach. But we’re working on it, and I have hopes that God will continue to heal me through doctors. But searching out wisdom from others as well, especially since my conventional doctor and the paleo-friendly doctor offer very different advice.

Again, I so appreciate your taking time to respond. It is encouraging to hear an affirmation of what I am/did do, and to hear encouragement and answers.

What you said explains a lot now. How many antibiotics did you take for Lyme?

What adrenal support are you on? Is it pharmaceutical or hydrocortisone or botanical?

As a vegetarian do you think you consumed a great deal of GMO corn and soy products?

Like Tim, I disagree with the starch free approach. It can be therapeutic initially however after 2-4 wks, the microvilli should grow back sufficiently to allow digestion of starches again. I find that it's helpful to supplement Betaine and pancreatic enzymes if it's not enough. The root causes of sibo/sifo need to be assessed and determined. Vegetarians also probably get higher exposure I believe to parasites, protozoa, works etc via raw salads.

Luckily, I grew up on a farm and so we had lots of fresh, organic veggies growing up, little processed foods (but grains and gluten) but we did eat lots of soy. I began losing weight at 16, and have never been able to regain. At that point I was hospitalized, and they crammed soda, twinkies, and ice cream and microwave dinners down us (seriosly, that was all we had... nothing fresh). I was there for about 2 months and absolutely miserable in pain with constipation. Never regained strength since then, but things went downhill. I spent some time overseas and picked up some parasites which have been addressed by my functional doctor (never found by conventional parasitologists).

I continue to grow weaker, though, so we are still looking for answers. At 25, it is hard to climb stairs. There must be life somewhere....

The conventional doctors still say "just eat more, cram it all down, even if you feel sick." I am not sure if that creates more gastric stress and thus hindering healing, and creating more feeding for SIBO.

Family history: history of constipation; my father has had chronic pain/tendonitis. He switched to paleo and went off pain killers for the first time in 20 years. : ) But other than that, uniquely healthy and strong. My grandma is 87 and still going; she has larger muscles than most men. Seriously.

There may be some autoimmune issues going on, as well—I have an undifferentiated connective tissue disorder. No one has been able to link it to my digestive issues. I also struggle with depression, but anyone who has done some research on SIBO and gut disorders knows the two go hand in hand. I had chronic insomnia (0-2 hours of sleep for 3 months straight; I was dead) but the adrenal support helped that immensely. So take Dr. Grace’s advice on that seriously!

So, lyme’s, and some parasites and insomnia have been tackled. I still am ridden with depression, anxiety, insomnia, extremely low T-3 but normal levels o T-4, severe anemia, chronic inflammation, chronic immune stress, low white blood count, messed up triglycerides…. And the conventional doctors ignore it and just say eat more; the two functional doctors off the beaten path I have seen have helped identify the Lyme’s and parasites but are unsure of what is causing the inflammation and immune stress, etc. Someone recommended live blood analysis. Is that a valid testing procedure? Something you recommend?

So, again, probably more info than you wanted. But perhaps it can help others searching for something called life, instead of just barely gasping through each day.

I forgot to say I have been on probiotics (prescript assist and dr. ohhira's) but my body is rejecting those right now.

I will show my doctor the articles on resistant starch and try to incorporate more fermented veggies. : ) And I comply with step #6 and try to get at least a 1/2 hour walk in, even if I don't feel I have the energy.

Gillian - You can never give too much info! Thanks for sharing. To me, it's obvious you have gut issues, but getting a stoopid doctor to believe that is another thing (sorry, Grace).

I'm also pretty sure you may have more problems than diet is going to cure. I like your 'don't eat' list, but wish you would be eating more starchy foods like potatoes, rice, and strange tubers. It looks to me like you are in the VLC category (very low carb). If you count carbs, try to get over 150g/day. 200g if possible. That means eating 2-3 potatoes or big bowls of rice a day.

You should look for the book "Potatoes not Prozac". You probably won't learn anything new, but it will cement what we have been discussing here.

I'd also like to encourage you to get some mental health counseling. I don't think you are crazy, but with depression and anxiety for so long you may be suffering PTSD just like a war vet would suffer. Don't be too proud to admit you need to see a shrink. Poor gut health and PTSD have been positively linked!

When I first met Grace, I thought the BG stood for Brain-Gut (actually it's Blood Glucose), but there can be no doubt brain and gut are one. You need to fix both.

My other advice for you is to find a doctor that will take you seriously. It sounds like your present ones are not. Maybe Grace has an inside track to picking a good doc.

Also, don't bother asking them about RS--they will look at you like you have horns growing out of your head. Just start taking a spoonful of potato starch with a couple of your meals. It won't hurt you and will most likely help you--it won't transform you overnight, but it will give your gut bugs a break and they might start liking you again.

No one who reads this blog should be satisfied with 'barely gasping through each day' I'm glad you found us here.

When I say 'us' I'm talking about Grace, me, and the thousands of people who read and have similar issues. I hope you keep posting to let us know what happens!Thanks,Tim

Tim--Thank you so much. And thank you for the reminder to all of the link between depression and gut disorder. The gut produces just as much serotonin as the brain does, thus the incredible link between the two. I have an MA in Counseling, ironically, but I will never think about mental issues apart from physical; I firmly believe the two interact.

I apologize if I missed a thread of comments elsewhere... I am very interested to hear whether people have found it better to take resistant starch (therapeutic supplemental doses, like your recommended potato starch/psyllium husk/ORAC greens) on an empty stomach, or with food? As a single dose, or spread throughout the day (and at what time(s))?

I'm wondering whether there would be superior blood sugar control with a spread-out-dose, but keep feeling like if I take starch with food...then the Farts Will Come.

I have a question for those doing both RS (plantain flour) and SBOs. I have been doing RS with plantain flour for about three weeks. So far no letup on the gas, but the gas from the RS is usually lower, colon mostly, I think. Just the plantain flour by itself has never given me painful gas, or the kind that makes me feel sick. I started Primal Defense Ultra a week ago, and was feeling good and noticing better digestion, especially of fats, and my unmentionables have gone from floaters to sinkers within the week. This really suggests to me that something is improving my fat digestion.

Both yesterday and today, however, I have begun to have really painful gas in my stomach and small intestine area (middle of gut, just above my belly button) building to a feeling that my stomach is going to have to explode to relieve the pain within about two hours after eating. I haven't eaten anything out of normal for me either day, and I don't remember EVER having stomach gas this bad before in my life. Since the gas was lower and different with the RS, I can only wonder if this is caused by the Primal Defense.

Has anyone else here experienced horrible gas and bloating that commenced after beginning the SBOs? Did it pass, or did you have to stop taking them? I don't want to have to stop taking them, but if this doesn't pass it won't be something that will be worth it for me to live with to improve my gut flora. That would seem like a bargain not worth the price.

I took some charcoal in water about a half hour ago, and seem to be feeling some relief, so I'm thinking it's definitely gas of some sort.

Hi, Ann - So many variables. Maybe try this: Cut out the RS completely except what you can get from naturally occurring sources in cooked potatoes and rice, a couple servings a day.

See how you feel after that before deciding to jump back into the RS supplementing. But, you may need to work extra hard on cleaning up some pathogens, it sounds like you have issues. What you are describing is definitely not normal, or at least not normal for someone with a healthy gut.

Sarabeth - I think we are all still learning the best ways to take the RS in supplemental forms, but intuitively, I think it should maybe be spread out in at least two servings and always accompanied with real food. The Amazing Grass that Grace likes is a great proxy for real food during a heavy supplement period as it contains lots of great fiber, flavonoids, and antioxidants found in a wide variety of fruit and vegetables.

A smoothy made with some raw potato starch or banana flour and Amazing Grass or similar, once or twice a day should be just right. No need to over-do it. In some cases more is not better. Start slow, especially with the potato starch and if things improve, keep at the lower end of the dosing. If things don't start to improve, thinking that quadrupling the potato starch is the next logical step is wrong. The next logical step is looking for pathogens and rebuilding gut flora, while making sure you are doing all 7 steps. So many people seem to want to gloss over everything and jump right on the potato starch. Not the intent! The potato starch part is only 1/7th of the program, and then not even a full 1/7th! So, keep that in mind, ya'all!

Tim - yes had the GI Effects 2100 - nothing too extraordinary, but SigA very low, and questionable fat digestion. Also low in all commensal bacteria, with the exception of fusobacteria, which was high. Acetate was 72, butyrate was10, propionate was 16, and vale rate was 1.5 - those are percentages. Low in lactobacillus, no opportunistic bacteria. No significant amounts of yeast/fungi. No ova or parasites seen. No inflammation. Ph was high at 6.9.

No campylobactor, c diff, shiga toxin e. Coli, and no h. pylori.

Does any of this suggest an obvious problem to you?

My functional med doctor said it was pretty classic patterning in a chronically stressed person, which I am. I have been the primary caregiver to my sixteen year old son who is profoundly disabled with cp. He has never slept well, so I haven't either.

I do have leaky gut, and have developed a lot of food sensitivities over the past year. Just started adding yogurt, kefir, and raw sauerkraut back in, all homemade, about three weeks ago, and tapioca flour last week. No problems until yesterday.

Should I leave off the Primal Defense as well for a couple of days?

I'm just confused about why I would start getting such violent gas in an area I don't usually have it. Could this be the flora shifting balance?

Also, wondering if anyone is familiar with "Theralac" probiotic? It says it has five strains of colonizing bacteria, yet I'm reading everywhere that we should not be relying on probiotic supps for gut repopulation, and should instead be eating fermented foods. I find this really confusing. If they are colonizing strains, aren't they expected to colonize?

Hi, Ann - The only thing that jumps out at me is high pH. That's pretty big, although maybe a bit unreliable. If it is high, it's bad. It means more colonization by pathogens and less by beneficial strains, same as what happens in your 'lady parts' is what happens in the gut. Bacterial Vaginosis is diagnosed easily with high pH. At high pH the normal flora dies off and invaders get in, causing problems.

Anyway, pH is lowered in the gut when you get gut bugs that produce short chain fatty acids , especially butyrate. These gut bugs are the ones found in fermented foods and the supplements recommended around here. The pH is only going to get lowered when the gut bug population is right, no pill you can take to do it for you! If you are on PPI's, you are in trouble.

Don't worry about all the conflicting advice, just listen to Grace. Read the stuff here like you would the free pamphlets in your doctor's office. It's not tailored specifically to you personally, but it is all good advice. If you are trying the 7 steps, and doing a good job with all 7 and don't see any improvement in 4-6 weeks, you need to get more help.

If you are experiencing pain and discomfort, and only 3 weeks in, just play with dosages and timing and if you just can't find a sweet spot, look into a consult with Grace or find a good doc you trust. Don't drag this stuff our forever, and don't be content to live in pain and misery.

I wish we could tie Grace to a live chat room and make her give advice until everyone in the world was better, but she just ain't having that!